| NPI | 1578125340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA KELLEY-FREEMAN CEO 800-867-2395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC0700X Psychologist Clinical | |
| 103TF0000X Psychologist Family | |
| 103TF0200X Psychologist Forensic | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 103TR0400X Psychologist Rehabilitation | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 163WA0400X Registered Nurse Addiction (Substance Use Disorder) | |
| 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |